Atypical Manifestations of Dengue Fever in Children

Abstract

Abstract Objective The burden of dengue fever (DF) is increasing rapidly worldwide. Several atypical manifestations of DF are being increasingly reported but there are no clear guidelines on their definition and management. Their timely detection and appropriate management might improve outcomes. We describe here our experience in managing atypical manifestations of DF in children and their outcomes in a teaching hospital in South India. Methods A retrospective chart review of children (1 month–18 years) hospitalized, between August 2017 and March 2018 with a diagnosis of DF (NS1 antigen or immunoglobulin M antibodies positivity), was done. The clinical details of the atypical manifestations are described. Results During the study period, 925 children were hospitalized with DF, of which 94 (10.16%) had severe dengue and 2 (0.21%) died. Among the 925 children, 7 (0.75%) had cardiac, 5 (0.54%) had neurological, 5 (0.54%) had hepatic, and 31 (3.3%) had immunological (infection-associated immune dysregulation) manifestations. Conclusion Most children with atypical manifestations of DF recover with supportive management. There is a need for a clear definition of atypical manifestations so that large prospective multicenter studies on incidence, optimum management, and outcomes can be done.